Spontaneous cerebellar hemorrhage in a young patient should prompt imaging to assess for underlying AVM or DAVF. CTA points to the abnormality, catheter angiography characterizes the nature of the arteriovenous shunting, differentiates DAVF from AVM, rules out associated flow aneurysms, and indicates whether endovascular intervention is possible.

In this case, the position of the nidus and relation to veins contribute to moderate surgical difficulty, and the access arteries favored microcatheter navigation with good arterial, nidal and local vein obliteration. Close follow up will be required to exclude recurrence.